As the Trump administration and Congress move toward taking another shot at repealing the Affordable Care Act, signs of trouble with the individual marketplaces continue to bubble up on the state level.
In Iowa, Wellmark Blue Cross and Blue Shield announced Monday that it will not sell or renew individual and family ACA exchange plans next year. The insurer has lost about $90 million in the ACA individual market in the last three years. It says the move will affect 21,400 of Wellmark’s members, or 1.3% of the individuals it covers in Iowa.
“Finding solutions to stabilize this market is in the best interest of all Iowans, including providers of healthcare and insurance carriers,” Wellmark Chairman and CEO John Forsyth said in the announcement. “While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.”
Minnesota, meanwhile, has had to resort to drastic steps to salvage its struggling individual market.
Gov. Mark Dayton said Monday that he wouldn’t block a measure, recently approved by the state’s legislature, that would spend as much as $542 million over the next two years to help insurance companies cover high claims costs, the Star Tribune reports.
However, noting that he is worried about the fact that there are no guarantees insurers will stay in the individual market despite the reinsurance funding, Dayton plans to let the measure become law without his signature.
Dayton likely has reason to worry. The Minnesota Council of Health Plans announced Monday that the state’s health insurers reported $687 million in operating losses for 2016, leading them to withdraw nearly $560 million from state-mandated medical reserves. State public programs accounted for more than half of the overall losses, followed by continued losses in the individual market.
“While information throughout last year pointed to some financial problems, $687 million is a much bigger number than I expected,” the group’s president, Jim Schowalter, said in the announcement.
News of these state-level struggles comes amid the heightened uncertainty faced by insurers that operate in the exchanges. Among one of their major concerns is the outcome of a lawsuit that could result in the disappearance of cost-sharing reduction payments.
In fact, a recent Jefferies report predicted that Anthem—one of the biggest players in the exchanges overall—might pull back from the markets considerably in 2018. Other insurers, like Humana, have already said they will exit completely next year.